Recently, Vinny Testaverde, pro quarterback for the New York Jets, was forced to end his season early due to rupturing his Achilles tendon. This is unfortunate for Jets fans, and of course, for Mr. Testaverde. This is a fairly common injury which can happen even to those of us who arent super athletes.

The Achilles tendon attaches the calf muscles in the back of the leg to the heel. It helps the calf muscle to flex the foot so that the toes point toward the ground. While generally a fairly strong tendon, it can be disrupted by injury, especially in middle age.

Achilles tendon rupture is fairly common in those of us who arent professional athletes. It often happens to "weekend warriors," or those who generally lead more sedentary lives, but occasionally engage in sports. The most common patients are 30 to 50 years old and are male.

The injury is usually described by patients as a "snap" or a "pop" in the back of the calf or leg. Commonly, this is noted when the patient begins to jump. In addition to local pain and swelling, the Achilles tendon may actually be noticeably interrupted when felt (a gap may be appreciated). There may also be some weakness when attempting to point the toes toward the ground. However, because there are other muscles in the back of the leg which can flex the foot in the same manner as the calf muscles, the weakness may be minimal. Read about Tendon Injuries and Disorders...Click here

Medications

NONSTEROIDAL ANTI-INFLAMMATORY DRUGS Also known as NSAIDs, this medication relieves pain and reduces inflammation. It is used to treat headaches, muscle aches, dental pain, menstrual cramps and athletic injuries. It is commonly used to treat pain, swelling and stiffness associated with arthritis. This medication can also reduce fever...More

If this injury is suspected, medical evaluation is needed. The treatment for Achilles tendon rupture generally involves wearing a cast, with or without surgery. In the case of a younger athlete who wishes to continue to compete at an intense level, surgery is generally recommended to get good re-alignment of the two ends of the tendon. Read about signs of tenditis and how it can be diagnosed...Click here

For many people with an Achilles tendon rupture, a cast alone may be appropriate treatment. Some surgeons have reported better strength and endurance as well as a decreased chance of repeat rupture after surgical repair as compared to casting alone. A decision is best made after consultation with an orthopedic surgeon, after he/she has had a chance to evaluate the individual case and discuss the risks and benefits of both treatments with the patient.

Regardless of the decision to perform surgery, a cast is usually required. The cast is usually worn from eight to twelve weeks. After the cast is removed, physical therapy is often prescribed to rehabilitate the affected leg muscles. This can be very important to maximize return of function.

Occasionally, there can be other conditions which can affect the Achilles tendon. Two other common problems are incomplete rupture of the Achilles tendon and tenosynovitis (inflammation) of the Achilles. Incomplete rupture, or a partial tear, of the Achilles is generally treated conservatively. Rest, elevation, pain medication (usually nonsteroidal anti-inflammatory medicines like aspirin, ibuprofen or naproxen) and later, rehabilitation are the main components of treatment.

Tenosynovitis

inflammation of a tendon sheath

Sometimes with an incomplete rupture, scar tissue can form which causes continued pain and movement limitations, and this must generally be treated surgically for the best result.

Tenosynovitis of the Achilles causes localized pain, which can be severe, and limitation of movement. There may also be a fine crackling sound heard on use of the ankle (called crepitus). The treatment is generally conservative, with rest, avoidance of pressure and local heat application. When it is necessary for the patient to walk, a pad may be prescribed to put under the heel in order to elevate the heel and minimize the need for movement of the Achilles tendon. Severe cases may require a walking cast for several weeks.

Crepitation

a grating or crackling sound or sensation (as that produced by the fractured ends of a bone moving against each other or as that in tissues affected with gas gangrene)

So, Vinnys out for the season and things are not looking so good for the New York Jets. Hopefully, hell be back next season as good as ever. Remember to stretch and warm up properly before engaging in any athletic activity. Otherwise, you may end up on the sidelines, too!

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